Coaching Primary Care Clinicians in the Ambulatory Setting: Direct Observation and Deliberate Practice.

Background And Objectives: Clinical coaching programs can improve clinician performance through feedback following direct observation and the promotion of reflection. This study assessed the feasibility and acceptability of a primary care coaching program applied in community-based practices.

Methods: Using a 31-item behavioral checklist that was iteratively revised, four faculty observed 18 community-based primary care clinicians (15 of whom were physicians) across 36 patient encounters.

Clinically Excellent Use of the Electronic Health Record: Review.

Background: The transition to the electronic health record (EHR) has brought forth a rapid cultural shift in the world of medicine, presenting both new challenges as well as opportunities for improving health care. As clinicians work to adapt to the changes imposed by the EHR, identification of best practices around the clinically excellent use of the EHR is needed.

Objective: Using the domains of clinical excellence previously defined by the Johns Hopkins Miller Coulson Academy of Clinical Excellence, this review aims to identify best practices around the clinically excellent use of the EHR.

The clinically excellent primary care physician: examples from the published literature.

Clinical excellence is the ultimate goal in patient care. Exactly what the clinically excellent primary care physician (PCP) looks like and her characteristics have not been explicitly described. This manuscript serves to illustrate clinical excellence in primary care, using primarily case reports exemplifying physicians delivering holistic and patient-centred care to their patients.

Ethical concerns related to grateful patient philanthropy: the physician's perspective.

Background: Philanthropic contributions to academic medical centers from grateful patients support research, patient care, education, and capital projects. The goal of this study was to identify the ethical concerns associated with philanthropic gifts from grateful patients.

Methods: A qualitative study design was selected.

Engaging youths with serious mental illnesses in treatment: STARS study consumer recommendations.

Objective: The purpose of this study was to identify better methods of engaging youths in mental health services by asking experienced mental health consumers for suggestions for clinicians.

Methods: 177 members of an integrated health plan, ranging in age from 16-84 years and diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, or affective psychosis, completed four in-depth semistructured interviews over 24 months as part of a study of recovery from serious mental illness. We transcribed and coded interviews, extracted a set of common themes addressing consumer recommendations to clinicians, and compared these themes across age groups.

Self-reported cancer rates in two rural areas of West Virginia with and without mountaintop coal mining.

Mountaintop coal mining in the Appalachian region in the United States causes significant environmental damage to air and water. Serious health disparities exist for people who live in coal mining portions of Appalachia, but little previous research has examined disparities specifically in mountaintop mining communities. A community-based participatory research study was designed and implemented to collect information on cancer rates in a rural mountaintop mining area compared to a rural non-mining area of West Virginia.

Do fears of malpractice litigation influence teaching behaviors?

Background: Medical malpractice is prominently positioned in the consciousness of American physicians, and the perceived threat of malpractice litigation may push physicians to practice defensively and alter their teaching behaviors.

Purpose: The purposes of this study were to characterize the attitudes of academic medical faculty toward malpractice litigation and to identify teaching behaviors associated with fear of malpractice litigation.

Methods: We surveyed 270 full-time clinically active physicians in the Department of Medicine at a large academic medical center.

Facing the malpractice crisis: academic physicians' willingness to accept quick fix solutions.

Background: We sought to determine the willingness of academic physicians to accept strategies to contain institutional malpractice costs.

Methods: We surveyed all 270 Department of Medicine physicians at a large academic center. Respondents were asked about their knowledge regarding malpractice premiums, willingness to reduce patient-care activities and accept decreases in compensation.

Experience, expertise, or specialty? Uses and misuses of a reference.

Objective: To analyze systematically the manner in which the results of a published study are presented in subsequent publications that refer to it.

Study Design: We identified a convenience sample of 121 scientific papers that referred to an often-cited 1996 study by Kitahata and colleagues. This study reported that greater primary care physician experience with AIDS was associated with lower mortality among their patients with AIDS.